Naturally stop or reverse progression of permanent AFib

I am in my late 60s. Eight months ago, my idle heart rate was consistently under 50. Two months later, it suddenly doubled, and I found myself in permanent AFib.

Before the onset, I enjoyed occasional running steep uphills of a local creek and paced hikes on rocky trails for 8-12 hours non-stop. Now, skipping steps up to a third floor is a challenge.

My cardiologist is a very good allopathic doctor, but diltiazem and metoprolol made my symptoms worse immediately.

All success stories and almost everything of help in medical literature (not my favorite reading ) is about paroxysmal or sedentary AFib and about triggers. There are no triggers and attacks for me: my HR has been chaotic every minute of last six months. Endurance guys like me, who went into permanent AFib straight from full capacity, are so few they can’t be heard even in the smallest of the choirs.

My new daily routine includes light interval training outdoors, garlic, omega-3, Zn, potassium, D3. Also on the list are Q10, Ceylon cinnamon, hawthorn, amino acids, curcumin with bioperine, pycnogenol, nattokinase – not all on the same day or month.

BP is under 120/70, cholesterol – under 190, BMI – 24, sitting is not a habit. No obvious stress, sleep – maybe OK, attempts to meditate are mediocre so far. Diet is mostly organic, everything from scratch, no spices and fancy recipes – very basic. More sugar than necessary is a concern, a cup of coffee is not.

Can someone share an experience of improving on permanent, not paroxysmal AFib, and I will happily share mine – would there be any?

Thank you!

Why do you say it’s permanent? Have you tried and failed antiarrythmic medication? What about electric cardioversion? A bit more history might help us here.

My story is similar. It came on after commando style gardening for a few hours. I was/am quite fit and didn't think it was a concern.
Was in permanent afib for about 4 months. On a 24 hour holter my HR was an average of 120 and peaking >170.
Had first CV which lasted for 1 hour. The second one is still lasting after over 2 years now.

My thyroid values were a bit off but they didn't think it should have caused afib so they called it lone afib.

Initially eating lots of vegetables, vegetable juice, hawthorn extract, avoiding trans fats, looking to up my omega 3 intake worked for me - maybe just lucky. I did take some Sotalol and anticoagulant up about 5 months ago.



Edited 1 time(s). Last edit at 03/28/2018 09:50PM by Joe.

My cardiologist believes that antiarrythmics will do no good in my case. He also thinks that electric cardioversion would be a treatment that is much worse than the disease and with little chance to improve the symptoms. For this stage, he is for a natural path.

I wasn't on a Holter monitoring but a Polar HR monitor shows 80-120 idle. Moderate walk is 120, slightly pushing on uphills, I try not to exceed 150 and occasionally reach 170. A year ago, reaching 170 on elliptical would be 10 times the effort.



Edited 1 time(s). Last edit at 03/28/2018 10:33PM by Enfibber.

Joe, that's funny: commando style gardening was in my chest with an ax and a one-man saw. Are you saying that you are AFib-free now?

Those rates are too high. I see from your original post that you did not tolerate metoprolol (beta blocker).

I would seek an EP consult. 6 months is nowhere near the “point of no return” from AF. I’m sure your cardio means well, but you need another team member.



Edited 1 time(s). Last edit at 03/29/2018 12:17AM by wolfpack.

I agree with the Advice from Wolfpack.

I would add that It's rare that people have been if continuous AFIB for very long, and then months later spontaneously convert out of it. If you are trying to treat it naturally, the conventional wisdom, is to try and figure out what triggers your AFIB, get a game plan to treat moving forward, and then get Cardioverted back to NSR, and hope to maintain the NSR naturally. A Shock to the Heart is actually natural, it happens in Nature when we have been shocked by lightning during thunderstorms.

The problem is that the longer you stay in AFIB, the less likely you will ever pull out of it, whereas if you got Cardioverted, and it lasted for awhile, the progression of bad electrical remodeling it at least halted for however long the Cardioversion holds.

Is your Cardio Dr. even a real Cardiologist? Or just a Dr. who specializes in Cardiology?

I have have fought my AFIB naturally as hard as anyone on this site, so I am all for trying to treat it naturally, but you have to get your AFIB HR down, even if it means taking Drugs. Their are different drugs available than the ones you tried. I suggest researching Cardio-Selective Beta-Blockers. They don't sedate your like the Metropolol.. I have used Bystolic and had great results. Also there are alternatives to the Diltiazem. Have you tried the Diltiazem by itself? Perhaps it was just the Metropolol that aggravated your symptoms?

You are tired while exercising probably because of 1 of 2 reasons. The most likely is that your Heart is pumping so fast that the Ventricles do not have time to fill with Blood before the Ventricles Contract. Because you are in AFIB, the Atria is Fibrillating, so you lose what is called "Atrial Kick" which is the process of the Atria pumping Blood down into the Ventricles. The Ventricles will still fill while in AFIB, but they need more time when Atrial Kick is lost.

The second possible reason for your exercise fatigue would be from a weakened Heart resulting from it beating so fast, while you have been in AFIB for these last 6 months. If you haven't gotten an Echo, I suggest one. This will tell you your Ejection Fraction (EF), and whether your Heart is weak, or just not pumping adequately because of the high HR.
Loss of Atrial Kick usually results in a lowering of EF by 5-7 percentage points. So for example if your EF was 60% before you had AFIB in NSR, then under AFIB conditions the EF would lower down to between 53-55%. Even with a loss of 5-7% points, people can still exercising at almost the same capacity by compensating for the loss of Cardiac output, by increased breathing, which helps to increase the oxygenation the Blood supply that is available.



Edited 3 time(s). Last edit at 03/29/2018 02:24AM by The Anti-Fib.

I'm with wolfpack - see a top notch EP as soon as you can. Let this forum know where you live and I'm sure some good recommendations will be forthcoming as to who to see and where.

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Enfibber
Joe, that's funny: commando style gardening was in my chest with an ax and a one-man saw. Are you saying that you are AFib-free now?

As far as i can tell and when on an EKG it shows ok. But the comments were: 'Sinus Bradicardia, Borderline first degree A-V Block, rSr' pattern V1 or V2, probable normal variant' - don't really understand it all and the cardiologist isn't concerned.
I do have occasional double beat and occasional missed beats - whatever they may be. I try not to let it stress me. When my diet is good i think i have fewer of those, or i might just imagine it to be so.

My cardiologist wasn't keen to have me cardioverted brcause . He only agreed to it because i asked for it.

Joe:

My EKG's have always been accurate as far as determining NSR or AFIB, but the additional info like your

"'Sinus Bradicardia, Borderline first degree A-V Block, rSr' pattern V1 or V2, probable normal variant' "
Those sorts of things are not very accurate, I get those all the time, and the Cardio Dr's are not concerned.

Thanks for that!

SInus bradycardia is just NSR with a rate < 60. Heck, mine drops to 44 bpm in the afternoon at times. It's no concern at all until it gets into the 30s or you have problems with blacking/graying out.

1st degree AV block is another relatively common one. For that you might consider a stress test to see what the P-R interval does. If it shortens under load, then it's probably nothing to worry about. I know pilots who fly with that condition. Again, worth talking to your doctor about but certainly don't lose sleep!

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Enfibber
My cardiologist believes that antiarrythmics will do no good in my case. He also thinks that electric cardioversion would be a treatment that is much worse than the disease and with little chance to improve the symptoms. For this stage, he is for a natural path.

I wasn't on a Holter monitoring but a Polar HR monitor shows 80-120 idle. Moderate walk is 120, slightly pushing on uphills, I try not to exceed 150 and occasionally reach 170. A year ago, reaching 170 on elliptical would be 10 times the effort.

While it's true that cardioversion is unlikely to bring lasting success, it's just not true that it's worse than the disease. I hope he really didn't say that because it's flat wrong.

Be aware that Polar HR monitors (and every sports-type monitor I've ever tried, which is almost all of them) fail miserably at measuring heart rates during afib. They just aren't designed or built to deal with irregular rhythms and they produce wildly inaccurate results, so I'm not sure you actually know what your resting heart rate really is. You need to get a Holter, event monitor, or a Kardia and find out what you're heart is doing for sure. Not sure why your doctor didn't do that.

But if your resting heart rate really is 80-120, that's far too high and needs to be controlled. Allowing a rate like that to continue unabated will lead to heart enlargement and subsequent heart failure. (I can introduce you to two people on another forum who are in heart failure now due to allowing rates like that to continue uncontrolled for months.) Go with natural solutions if you want, but you need to find something to bring that rate under 100 and keep it under 100 consistently.



Edited 2 time(s). Last edit at 03/30/2018 02:32PM by Carey.

Thanks wolfpack! Don't know why the GP and Cardiologist didn't tell me that. Suspect they don't want to wast their time.

Thank you all for the information, hints, and advice. I am not fixated on going natural – only if possible. I do not believe in fully natural healing of systemic problems. Unlike a cold or tumor, there is no virus or distinct anatomic abnormality to blame for a sudden onset of AFib: this is why I hoped for a not near-zero chance. Now, “I'm reviewing the situation”.

Yes, my cardio doctor is a real cardiologist and he performs CV but does not believe that CV can help me. I was wrong about CV being worse than AF: he said "ablation", not CV. Another correction: my list of supplements includes Mg, not Zn.

I will seek second opinion though.

Results of Doppler:
1. Both atria are moderately dilated, mild concentric hypertrophy of the left ventricle (endurance?)
2. Systolic function at lower limits of normal
3. Mild regurgitation of mitral, tricuspid, and pulmonic valves
4. No aortic, tricuspid, and pulmonic stenosis
5. Normal motion of left ventricle wall
6. Pulmonary artery peak systolic pressure - 37 mmHg, right atrial pressure – 15 mmHg
7. Pericardium is normal
8. Left EF 50-55% (13 years ago – calculated 55%, too low for endurance?)
9. E/E' ratio is 12
10. Many more numbers ...

Diltiazem 120 mg had no effect on BP of 115/70 and on peak & idle HR, but something became immediately wrong – can’t describe, all returned to normal immediately after quitting.
Metoprolol 25 mg did not affect any numbers but put some invisible brakes on me and did not allow to walk faster than at a leisure pace.

I never feel tired, even with AFib that does not let me run and walk fast. I do not have any triggers: HR is chaotic every minute and nothing makes it better or worse.

I wore my Polar HR monitor again and found that it is surprisingly precise in blinking on every heartbeat. My program of moderate interval training and supplements worked: current numbers are better than recently: all but the most important – HRV. Idle HR is 60-80 sitting and 70-90 standing at my PC. Paced walk: 100-120 on the 100 side. Recently it was 120 at a moderate speed. I can run short steep uphills without a change in HR, which is 100-120-140 on a hilly trail. At home, doing nothing, HRV is at full swing: 80-125.

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Enfibber
Unlike a cold or tumor, there is no virus or distinct anatomic abnormality to blame for a sudden onset of AFib: this is why I hoped for a not near-zero chance.

Actually, there probably is a distinct anatomic abnormality to blame. Do a search on atrial myopathy. For example, [circ.ahajournals.org]

Yes, Carey, you are probably right to the point. Based on my history, I even suspected something of that nature.

Carey, i just read the link. Makes my head spin a bit but also explains the shotgun approach by my cardiologist. Don't know if they can't or don't want to investigate the underlying cause of AF for better treatment outcomes.
Chronic inflammation or low grade inflammation seems to be a huge factor?

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Joe
Don't know if they can't or don't want to investigate the underlying cause of AF for better treatment outcomes.

Too complex and not much money while we are still 1%. Not in my lifetime

There's plenty of research going on, and they're getting closer to fully understanding afib, but they're just not there yet.

My personal prediction is that afib is a genetic disease. You're born with the afib gene or you're not. Lifestyle choices can influence when your afib manifests itself, and perhaps even if it manifests itself, but you have to have the underlying genetic disposition first. That would explain why the world is full of obese, smoking, drinking, sedentary people who don't have afib, and healthy, non-smoking, non-drinking, active people who do. This is also why I'm skeptical that anything other than ablation can reliably stop afib at this time. That will change in the future, but probably not in time for any of us. I predict our kids will have their afib treated with gene therapy and ablations will be a thing of the past.



Edited 1 time(s). Last edit at 04/03/2018 10:01PM by Carey.

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Carey
... genetic disease ... Lifestyle choices can influence when your afib manifests itself, and perhaps even if it manifests itself ... active people who do <have AFib> ... will change in the future

Another good shot at my case, both genes and lifestyle. My genes are not exactly AFib, but sure heart related.
Future? Not sure: no one can tell what will be on the plate for our children.
I am grateful for my lifetime and epoch, even if my AFib will follow the path depicted in the first drawing.
La vita è bella!
<no, I don't speak Italian and did not watch the movie>

Unfortunately you are probably correct, Carey.

My sister who is 2 years younger had her first AF 5 to 10 years ago (lost track of time). Interestingly, her afib stopped by taking thyroxin. Her GP didn't want to give it to her because her thyroid values were within normal range.
I asked an alternative (medical scientist) practitioner and he predicted that her T values would be good but not good for her and she should take thyroxin at a reducing dosage.
After a month she stopped taking the thyroxin and her afib was back. She began taking it at a reducing dosage and kept free of AF for a few years.
Now she is on beta blockers and anticoagulants.

A lot of our medical problems are no doubt because of our DNA, but it does skip around, my mother had AF, didn't start until the age of 80 and she went into it permanently. I have 2 brothers and they never had any episodes of AF. It is possible I might not have gone into AF if I had not taken too much thyroid meds. which made me hyper.

Liz

Carey - I agree. That’s undoubtedly most likely. There have been some studies linking various genetic mutations or flaws to underlying causes that can promote the development of Afib. One is the missense mutation in the voltage-gated potassium channel that relates to autosomal dominant hypomagnesia and that certainly makes sense. There are probably many more, but since that approach apparently has not been actively pursued for arrhythmia, as ablation offers the solution to the afib without first assessing gene status.

But, the underlying question remains … that without knowing the mutations and taking steps to compensate for flaws, does that mean the only manifestation is Afib? Most likely not. I wonder what else might be going on from a faulty gene working behind the scenes now that I no longer have the Afib “alert” symptoms of …let’s say for example… the magnesium mutation… or what if it isn’t the magnesium gene but another, yet unidentified and silently or unsymptomatically undermining functional health? I’m not losing sleep over it, but as more younger people present with Afib, certainly, a genetic assessment makes sense so all of the potentials of the flaw manifestations are ‘on the table’ for management and longevity.

In the rapidly-expanding field of Epigenetics, the focus is that once a gene mutation is identified, you can overcome the expression of that gene by various therapies including nutritional interventions. (Just as George has described his aggressive approach for his ApoE4 gene).

Since afib has been gaining in incidence continually for longer than 20 years, you’d think that genetic research for causative markers would soon be a priority as it’s certainly a costly for insurance companies to pay for multiple procedures, as is often the case.

Jackie

Yes Jackie and Carey,

Genetic research is one of the, if not the, most active sub-fields of AFIB research focus now... and has been a key focus of front line scientific research into
AFIB/All Arrhythmia Research for as long as I’ve been going to the major AFIB-related EP conferences each year!

Genetic origins for AFIB are increasingly better appreciated and recognized throughout the field and this strong trend is only growing with ever larger grants and multi-Center genetic research projects each year across the globe including at St Davids Med Center’s highest volume AFIB Research Center in the world.

The main point being, that the search for genetic links and origins is far from just wasting away on the sidelines. There is a very mature and highly-focused effort world-wide in this very area of genetics and both atrial and ventricular arrhythmia. Each year I’m always very impressed by the latest insights in this obvious connection for so many of us with a clear familial/genetic component to our own battles with the beast!

Cheers!
Shannon

Thanks, Shannon – good to know and encouraging for the future…hopefully, soon.

Have you heard any comments on panel tests specific for arrhythmia similar to something like the 23andMe assessments?

Best to you,
Jackie

My concern for the original poster Enfibber is that if you have been in afib for the last six months the chances of a clot forming are increasing. Stroke because of clot is real. It happened to me.

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Victoria
My concern for the original poster Enfibber is that if you have been in afib for the last six months the chances of a clot forming are increasing. Stroke because of clot is real. It happened to me.

Yes, Victoria, thank you for the warning! It is very timely. Real possibility of either ischemic or hemorrhagic stroke is my real concern. I asked for a second opinion with another cardiologist a few hours ago.

Enfibber:

8. Left EF 50-55% (13 years ago – calculated 55%, too low for endurance?)

No, I don't think that is too low for Endurance Exercise. 50-55% is low normal. Normal EF is usually stated as 55-70% I'm thinking you might be able to do moderate endurance exercise like long hikes, provided that you control your AFIB HR, and slow it down enough for the Ventricles to fill with Blood prior to being pumped out. Maybe experiment with using a Rate-Control Drug.

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The Anti-Fib
Left EF 50-55% ... 50-55% is low normal ... control your AFIB HR, and slow it down enough for the Ventricles to fill with Blood prior to being pumped out. Maybe experiment with using a Rate-Control Drug.

Yes, this is what puzzles me: my EF is 55% at least from mid-50s. Between that and 60, I was never second to much younger fellows ultramarathoners (non-elite) on endurance hikes and was never exhausted. Then, I was forced into a six-year break to take care of others. AFib jumped in in two years after return. Now, I am facing a real possibility to become in need of care myself: stroke risk is higher in permanent AFibbers.

Scheduling an appointment with a good cardiologist for a second opinion will take months. Meanwhile, I am trying to draw a line that is moving as chaotically as my idle HR: what is my exertion limit for the day? I pay when it is exceeded, too much slack accelerates clotting.

More numbers from Doppler – thickness greater than normal: LV PW ED 1.1 cm, IVS ED 1.4 cm, LA ID A-P ES 4.5 cm.

Rate control drugs: any advice looking at my Doppler and numbers?

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Enfibber
Rate control drugs: any advice looking at my Doppler and numbers?

I don't think rate control is fine science. You start with a beta blocker, preferably one that minimizes fatigue such as bystolic, and then arrive at a final choice based on trial and error.

Hi Enfibber, I hope you get some relief soon.

I had nine years of progressively worsening a-fib, and the last year and a half I was in full time 24/7 a-fib. At one point I did have a cardioversion, and it did last for about a year.

Your comments about your years of very advanced hiking brought back a memories of a couple of people I know. Both were avid cyclists that put in hundreds of miles a week on their bikes. One ended up with a pacemaker, the other a-fib. Both were super trim, super buff. The one that had the a-fib said something about that "it is an occupational hazard among cyclists", and that many got it. He said cyclists spend much at their time at near or max heart rate, and that had some permanent effect on the heart. This link may help.

[www.google.com]

Anyway, I know the feeling about beta blockers and calcium channel blockers. Can't live with them, can't live without them. For sure you feel a little more yourself without them, but it just doesn't leave your heart much "head room" to go any higher. You just have continued breathlessness. And while on them, the worst turn a person into a zombie, the best ones just sluggish and out of sorts.

I ended up having an ablation over four years ago by Dr. Natale, you'll see his name over and over. I was reborn that day, really and truly. I'm not on any rate control at all, I just took my pulse and it's 74 and my O2 is 98. And it's true that a good many ablations are a disaster if not done an EP with extreme talent, of which there are very few.

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Carey and onewaypockets

I don't think rate control is fine science. You start with a beta blocker ... then arrive at a final choice based on trial and error.

... feeling about beta blockers and calcium channel blockers. Can't live with them, can't live without them. ...
ablation over four years ago by Dr. Natale, ... an EP with extreme talent.

Yes, this is the way to go. Thank you!

BTW, I just learned that endurance usually results in lower than typical rest LVEF.

Carey you are spot on...my father had AF, my grandfather had it,some of my mothers siblings died quite young in their 30's of chest complaints. I'm the only sufferer out of 6 kids that has it, but my very fit and healthy 47 year old son has recently been told he appears to have an electrical problem with his heart?

I've said nothing at this time, don't want to scare him he lives in the USA so if and when he needs I will pass on this site.

I think genetics and DNA are truly the cause of a lot of chronic illness and disease. Cancer also runs in my family way way back in my family history, my other granddad died of stomach cancer, my father of bladder cancer and my son of bone cancer. Dr's say not related but I disagree.

I think future research will show us things we never dreamed of.